1. Field of the Invention
The present invention relates to lower limb prostheses in general, and, in particular, to a shock module prosthesis having a spring and/or fluid resilient element for smooth impact absorption during use of the prosthesis, and also having an adjustable torque-resisting cuff permitting rotational compliance of the lower leg and foot.
2. Description of the Related Art
Various types of lower limb prostheses are known in the prior art. Such devices generally include some form of attachment for coupling the device to the dorsal end of the limb and a leg and/or foot member extending to the ground to support an amputee""s weight. These devices generally attempt to simulate the structure and/or the performance of the human leg and foot.
Among the features desirable in a lower limb prosthesis is the incorporation of some means for providing impact absorption and/or dampening during use of the prosthesis, without sacrificing the ability to reliably and predictably support the amputee""s body weight. Such impact absorption permits the amputee to participate in activities with comfort and minimal stump trauma, hence allowing the amputee to be mobile for longer periods of time. Also desirable is a convenient means to selectively adjust the degree of impact absorption to suit the particular attributes (e.g., weight) and activity (e.g., walking, running, jumping, etc.) of the amputee.
Impact absorption or, alternatively, shock absorption is normally achieved by the utilization of some form of resilient means, such as a spring, a member fabricated from a resilient material, or a compressible fluid. It should be understood that impact absorption in a prosthesis is simultaneously accompanied by energy absorption/storage and eventually energy release. Such energy release during use of the prosthesis usually aids in forward motion by providing lift and thrust forces to the foot region, thereby permitting the amputee to expend less energy.
Impact absorption in lower limb prostheses is typically achieved by utilizing two or more elongated telescoping members with a resilient means disposed therebetween. Axial forces acting on such members cause relative axial or, alternatively, longitudinal motion between them, with the resilient means providing energy storage and release. Furthermore, optimal performance of such prostheses occurs when there is maintained between these members a smooth relative motion. Unfortunately, a limitation of many such devices is that dirt, debris, and other such particles are free to enter the interface between the telescoping members and upset the smoothness of their relative motion. Thus, it is desirable to incorporate a means for restricting such entrance of dirt, debris, and other particles.
Another desirable feature of lower limb prostheses is the incorporation of some means for allowing rotational compliance of the lower leg and foot relative to the stump of the amputee. Such rotation is beneficial and simulates the action of a natural human knee/ankle in a number of activities that involve the twisting of a person""s body with respect to their planted foot, such as golf, tennis, and the like. Rotational compliance in lower limb prostheses is typically achieved by utilizing telescoping members as described above, wherein the interface between such members is cylindrical, permitting them to rotate with respect to each other. However, unrestrained compliance is undesirable, as the foot would be free to twist unnaturally. Thus, it is desirable to incorporate a means for providing torsion-resistance against the rotation of the lower leg and foot relative to the stump of the amputee, and for returning the foot to its natural forward orientation after each rotational movement. Also desirable is a means for selectively adjusting the degree of torsion-resistance, to suit the particular attributes and activity level of the amputee.
The prior art describes many energy storing prostheses which utilize resilient means to cushion impact forces and/or to accentuate the amputee""s movements. An example is U.S. Pat. No. 4,883,493 to Martel et al. which illustrates a lower limb prosthesis comprising a pre-loaded heavy duty coil spring and a damper piston mounted between telescoping shafts, using air as a compressible damping fluid. Although this prosthesis provides impact absorption, it encompasses several limitations. One limitation is that the pre-loaded spring provides for a jarring effect at foot/ground contact and a hard stop at spring extension. Such impact shocks may be tolerable to an athlete during running but are unreasonably uncomfortable for an ambulatory amputee. Another limitation is that the bolt-slot assembly restricts any rotational motion of the lower leg and foot. Another limitation is that the prosthesis utilizes the bolt-slot assembly to maintain the vertical position of the damper piston as the stump-supporting shaft vertically oscillates. As a result, the bolt experiences high shear stress caused by the pressure exerted against the damper piston by the compressed air during energy release and thrust. Moreover, the bolt is also vulnerable to shear stress associated with the twisting of the amputee""s body with respect to their planted foot, as described above. These undesirable stresses adversely influence the performance of the prosthesis and necessitate frequent maintenance thereof. Yet another limitation is that there is no means for keeping atmospheric debris from entering the interface between the shafts, necessitating frequent disassembling and cleaning.
An example of a prosthesis which provides impact absorption, rotational compliance, and torsion-resistance is set forth in U.S. Pat. No. 5,458,656 to Phillips. In the preferred embodiment of this invention two telescoping cylindrical pylon members are connected by one or more elongated leaf spring elements, Normal and torsional forces imposed on the pylon members cause relative motion therebetween. A corresponding storage/release of energy in the leaf spring element(s) concurrently provides both impact absorption and torsion-resistance. The storage of energy associated with impact absorption is provided by an outward flexure of the leaf spring element(s). In contrast, the storage of energy associated with torsion-resistance is provided by a twisting of the leaf spring element(s).
Although the prosthesis of Phillips ""656 utilizes a highly adaptable and effective design, it is very expensive to manufacture and has several characteristics that limit its clinical efficacy. One characteristic is that in order to vary the degrees of impact absorption and torsion-resistance the amputee must replace the leaf spring element(s), which is somewhat inconvenient. Another characteristic is that axial and torsional forces can cause excessive bending and twisting of the leaf spring element(s) which can create local regions of undesirably high stress. Another characteristic is that the outward flexure of the spring element(s) results in a larger effective width profile for the prosthesis, which can make cosmetic finishing more difficult. Yet another characteristic is that there is no means disclosed for keeping atmospheric debris from entering the interface between the pylon members.
A more recent U.S. Pat. No. 5,702,488 to Wood et al. describes another prosthesis that provides impact absorption, rotational compliance, and torsion-resistance. Impact absorption is provided via compression of a compressible volume of fluid which is enclosed between a piston head and cylindrical piston chamber. Torsion-resistance is provided by four resilient cushions that impede the rotation of a torsion key attached to the piston head.
Unfortunately, there are a variety of limitations associated with the prosthesis illustrated by Wood ""488. One limitation is that it has a complex design, including the placement of an O-ring seal, a wear ring, two O-ring bumpers, and a retainer block within the interface between the telescoping piston head and piston chamber. This design translates into a heavier, expensive prosthesis that requires high maintenance and frequent adjustment. Another limitation is that torsion forces applied to the prosthesis result in local regions of undesirably high stress in the torsion key, which necessitates frequent maintenance. Another limitation is that the compressible fluid, by itself, provides less impact absorption than other prostheses. Another limitation is that there is no means for varying the torsion-resistance of the prosthesis, except for replacing the resilient cushions, which is inconvenient and cumbersome. Vet another limitation is that there is no means for keeping atmospheric debris from entering the interface between the piston head and piston chamber.
Of course, other shock absorbing means in prostheses simply induce a cushioning effect by utilizing strategically placed resilient materials, such as, for example, lubber in a prosthetic foot, socket liner, or stump socket. Those of ordinary skill in the art will readily comprehend that such cushioning means are of limited effectiveness and can only serve in a secondary capacity. Also, such shock absorbing means are typically integral with the foot or socket/liner and thus cannot be used with other prosthetic feet in a modular manner.
Thus, although the prior art illustrates many impact absorbing prostheses, none provide the benefits of selectively adjustable impact absorption, rotational compliance, conveniently adjustable torsion-resistance, and a means for preventing debris from entering and upsetting the smoothness of the relative motion of telescoping members, all in a relatively simple but highly effective construction which may be utilized in combination with a broad selection of prosthetic feet and sockets in a modular manner.
Accordingly, it a principle object and advantage of the present invention to overcome some or all of these limitations and to provide an improved shock-absorbing lower limb prosthesis.
In accordance with one embodiment, the present invention provides an impact and torque absorbing prosthetic shock module comprising an outer pylon, an inner pylon telescopingly engaged with said outer pylon so that an annular interface is formed between the pylons, a resilient element resisting relative axial displacement of the pylons, and a torque-resisting cuff providing torsional resistance to relative rotational motion between the pylons. The inner pylon is adapted to move axially and rotationally with respect to the outer pylon.
In accordance with another embodiment, the present invention provides an impact and torque absorbing prosthetic shock module comprising an elongated upper pylon, an elongated lower pylon adapted to move axially and rotationally with respect to the upper pylon, a resilient element resisting relative axial displacement of the pylons, and a torque-resisting cuff providing torsional resistance to relative rotational motion between the pylons. The longitudinal axes of the upper and lower pylons are maintained in a generally colinear alignment.
In accordance with another embodiment, the present invention provides a shock absorbing prosthesis comprising an upper support member, a lower support member, and a flexible tubular member. The upper and lower support members are coaxially and slidably supported relative to one another. The flexible tubular member is secured between the upper and lower support members so as to provide resistance to relative rotation between the upper and lower support members.
In accordance with another embodiment, the present invention provides an impact absorbing lower limb prosthesis comprising an outer tube, an inner shaft, and a coil spring. The outer tube has a longitudinal interior, a proximal end and a distal end. The longitudinal interior has a polygonal cross-section along at least a section of its span. The distal end is attachable to a prosthetic foot. The outer tube houses a support within its interior. The inner shaft has a proximal end, a distal end, and a longitudinal cavity. The proximal end is attachable to a socket for receiving a stump of an amputee. The inner shaft has a polygonal outer cross-section that is closely enveloped by at least a portion of the section of the longitudinal interior of the outer tube. The inner shaft is mounted to move axially with respect to the outer tube. The coil spring has an upper portion residing in the longitudinal cavity of the inner shaft and an upper end fixed in position relative to the inner shaft. The coil spring has a lower end attached such that the lower end is fixed in position relative to the outer tube. The coil spring is capable of a smooth response to loading and unloading via compression and extension, the compression and extension of the coil spring controlling relative motion between the outer tube and the inner shaft. The loading/unloading characteristics of the prosthesis to vertical compressive loads may be adjusted according to the particular weight of the amputee by selectively varying the spring characteristics of the coil spring.
In accordance with another embodiment, the present invention provides an impact absorbing lower limb prosthesis comprising an outer tube, an inner shaft having a hollow interior and being reciprocatingly interfitted with the outer tube, and a resilient means operatively attached or disposed between the outer tube and the inner shaft, The resilient means is provided by an internal coil spring that is free of pre-loading stress so as to provide a smooth or non-jarring compression initiation and a smooth or non-jarring extension termination. The prosthesis simulates a shock absorber when subjected to vertical compressive loads.
In accordance with another embodiment, the present invention provides an impact and torque absorbing prosthetic shock module comprising an outer pylon having a proximal end and a distal end, the outer pylon having at least one internally threaded surface, and an inner pylon having a proximal end and a distal end telescopingly engaged with the outer pylon so that an annular interface is formed between the pylons. The inner pylon is adapted to move axially and rotationally with respect to the outer pylon. A resilient element is provided within the inner pylon having a proximal end and a distal end and being sized and configured to resist relative axial displacement of the pylons. A torque-resisting cuff connected to the pylons provides torsional resistance to relative rotational motion between the pylons.
In another embodiment, the present invention provides an impact and torque absorbing prosthetic shock module comprising an elongated upper pylon and an elongated lower pylon adapted to move axially and rotationally with respect to the upper pylon. At least one of the upper and lower pylons has an internally threaded surface. A resilient element having a proximal end and a distal end resists relative axial displacement of the pylons. A support member is threadingly engaged with the internally threaded surface, the support member providing a base for supporting one of the ends of the resilient element. The longitudinal axis of the upper pylon and the longitudinal axis of the lower pylon are maintained in a generally colinear relationship.
In another embodiment, the impact and torque absorbing prosthetic shock module comprises a first pylon having a proximal end and a distal end, and a second pylon having a proximal end and a distal end. A resilient element comprising a plurality of interconnected disks is also provided, the resilient element having a first end connected to the first pylon and a second end connected to the second pylon.
In another embodiment, the present invention relates to an improved lower limb prosthesis which comfortably reduces impact or shock forces upon the stump of an amputee resulting from a variety of activities ranging from passive to strenuous. A vertical shock absorbing prosthesis constructed in accordance with the present invention is detachably positioned between a prosthetic foot member and a prosthetic knee or a socket for receiving the stump of an amputee. Preferably, a substantially rigid inner pylon is slidably received within a substantially rigid outer pylon. A compression member or assembly having predetermined load-deflection characteristics is contained within the pylons and provides increased comfort for the amputee during both normal and impact loading on the lower limb.
During a normal walking motion, a person""s gait or stride results in a cycle of compression and decompression of the lower limb, as contact with the ground transmits forces or loads upward toward the torso. In accordance with the present invention, adjustment of the lower limb prostheses can be achieved by choosing a compressible member having desired deflection characteristic in response to the loading/unloading cycles. Aside from size or length restrictions, such a compressible member is chosen to be stiffer for a heavier person and softer for a lighter person. In accordance With one embodiment, a compressible member having a nonlinear spring characteristic is provided which increases in stiffness as compressed. Thus, during more vigorous activities, or if a larger impact loading is encountered such as when the amputee suddenly has the need to jump or run, the spring will not xe2x80x9cbottom-outxe2x80x9d or reach maximum deflection. During less vigorous activities, however, the spring will retain more compliant characteristics so as to provide cushioning on amputee""s stump from the impact forces.
In one preferred embodiment, Belleville springs are arranged within the inner and outer pylons. The springs are stacked such that they alternately have their concave sides up, down, up, down, etc. in order to allow them to compress to store energy. Belleville springs have a well known non-linear deflection response to loading. Thus, the arrangement results in a relatively compliant foot at low spring deflections and continued compression of the shock absorbing prosthesis at nearly the maximum deflection of the springs. During activities where a high impact load is applied to the prosthesis, such as when jumping, the springs and pylons do not xe2x80x9cbottom outxe2x80x9d or stop moving abruptly, but instead reach their point of maximum compression somewhat more gradually.
In another aspect of the present invention, a compression member comprising a compressible medium such as a gas is provided within a chamber of the outer pylon. The compressible medium preferably has a nonlinear displacement or deflection response to loads which provides compliance of the present prosthesis that is more comfortable for the amputee during normal and impact loading types of activities.
For purposes of summarizing the invention and the advantages achieved over the prior art, certain objects and advantages of the invention have been described herein above. Of course, it is to be understood that not necessarily all such objects or advantages may be achieved in accordance with any particular embodiment of the invention. Thus, for example, those skilled in the art will recognize that the invention may be embodied or carried out in a manner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other objects or advantages as may be taught or suggested herein.
All of these embodiments are intended to be within the scope of the invention herein disclosed. These and other embodiments of the present invention will become readily apparent to those skilled in the art from the following detailed description of the preferred embodiments having reference to the attached figures, the invention not being limited to any particular preferred embodiment(s) disclosed.